Provider Demographics
NPI:1548803331
Name:WENNINGER, KATHERINE GAIL (MSW, LISW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GAIL
Last Name:WENNINGER
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:GAIL
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LISW
Mailing Address - Street 1:3454 OAK ALLEY CT STE 504
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1356
Mailing Address - Country:US
Mailing Address - Phone:419-318-8533
Mailing Address - Fax:
Practice Address - Street 1:3454 OAK ALLEY CT STE 504
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1356
Practice Address - Country:US
Practice Address - Phone:419-318-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1904488172V00000X
OHI21026601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker